- Registration and analysis of surgical complications: Bearing the burden of broken butterflies
- Award date
- 17 April 2015
- Number of pages
- Document type
- PhD thesis
- Faculty of Medicine (AMC-UvA)
The research in this thesis focussed on the quality of the complication registration in hospitalised surgical patients, in particular as to the recording of detailed information about the incidence, number and grade of occurring complications. Additionally, the voids in the current complicationregistration and several initiatives for improving the quality of complication data were addressed. Finally, insight in the hospital costs of surgical complications was gained.
Particular, complications that occur after discharge tend to be overlooked. This implies that a possible rising trend in minor complications will be missed, which would preclude improvement initiatives that could easily lead to a reduction of costs and patient burden. Complications after, for example, pancreatic surgery can triple hospital costs. A trigger tool appeared effective to detect patients at risk of complications resulting in a complete and reliable registration. Furthermore it seems unlikely that uniform complicationregistration is currently performed given the considerable differences in interpretation between surgeons and hospitals. More agreement on a national level about the definition and specific clinical situations is prerequisite for benchmarking.
Working in multidisciplinary teams has become increasingly more important in healthcare and this pleads for a more consistent registration of all complications, meaning that all complications of a patient developed during the hospital stay should be registered, regardless of which specialty identified the complication. Effort should be made to implement systematic electronic storage and automated triggers in modern hospital data systems. Further, valid data from complicationregistries is mandatory for the use of prediction models and risks of interventions in decision-making systems.
- Research conducted at: Universiteit van Amsterdam